RESUMEN
Deliveries with forceps or vacuum-extraction increase the incidence of perinatal craneoencephalic lesions, for which reason cesarean sections are performed more frequently. We report 3 cases of cranial lesions due to forceps deliveries, 2 with depressed skull fractures and 1 with a depressed fracture and an associated epidural hematoma. Diagnosis is made on clinical and radiological founds with CT scan or MRI. Treatment is surgical and consists of elevation of the depressed fracture and evacuation of the hematoma. The correct use of forceps is very important to avoid this kind of lesions in the newborn, especially in cases of difficult delivery.
Asunto(s)
Traumatismos del Nacimiento/etiología , Forceps Obstétrico/efectos adversos , Fractura Craneal Deprimida/etiología , Femenino , Hematoma Epidural Craneal/diagnóstico , Hematoma Epidural Craneal/etiología , Hematoma Epidural Craneal/cirugía , Humanos , Recién Nacido , Embarazo , Fractura Craneal Deprimida/diagnóstico , Fractura Craneal Deprimida/cirugíaRESUMEN
Los partos asistidos con forceps o vacuum aumentanla incidencia de lesiones craneoencefálicas fetales,siendo la tendencia actual a realizar cesáreas en partosque se prevén difíciles.Presentamos una serie de tres casos de lesionescraneales secundarias a parto asistido con forceps, doscasos de fracturas deprimidas y una fractura deprimidacon hematoma epidural subyacente. El diagnóstico serealiza con la clínica y técnicas de imagen como TACo IRM. El tratamiento es quirúrgico en la mayoría decasos, con elevación de la fractura y evacuación delhematoma.La forma correcta de aplicar los forceps resultaesencial para prevenir lesiones craneales fetales, especialmenteen partos difíciles (AU)
Deliveries with forceps or vacuum-extractionincrease the incidence of perinatal craneoencephaliclesions, for which reason cesarean sections are performedmore frequently. We report 3 cases of craniallesions due to forceps deliveries, 2 with depressedskull fractures and 1 with a depressed fracture and anassociated epidural hematoma. Diagnosis is made onclinical and radiological founds with CT scan or MRI.Treatment is surgical and consists of elevation of thedepressed fracture and evacuation of the hematoma.The correct use of forceps is very important to avoidthis kind of lesions in the newborn, especially in cases ofdifficult delivery (AU)
Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Traumatismos Craneocerebrales/etiología , Forceps Obstétrico/efectos adversos , Complicaciones del Trabajo de Parto , Traumatismos Craneocerebrales/diagnóstico , Traumatismos Craneocerebrales/cirugía , Traumatismos CraneocerebralesRESUMEN
We report a large series of 48 childhood spine tumors diagnosed and treated at our Hospital between 1986 and 2006. Spinal tumors in children are a rare and heterogeneous condition that frequently are diagnosed late because of their uncharacteristic clinical picture. Symptoms are usually limited to diffuse back pain or spinal deformities, prior to leg paresis or sphincter dysfunction. Diagnosis is usually made with MRI or CT. Treatment is surgical in most cases. The prognosis is variable due to the diverse histological findings and it may require the use of complementary treatments as chemotherapy or radiation.
Asunto(s)
Neoplasias de la Columna Vertebral/patología , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Imagen por Resonancia Magnética , Masculino , Pronóstico , Neoplasias de la Columna Vertebral/diagnóstico , Neoplasias de la Columna Vertebral/fisiopatología , Neoplasias de la Columna Vertebral/terapiaRESUMEN
We report a large series of brain-stem tumors seen during 18 years of at our hospital. We diagnosed and treated a total of 42 patients between 1988 and 2006; 36 of them were operated with partial resection in most cases. Brain-stem tumors constitute a rare condition with very bad prognosis. A surgical complete resection of the mass is not possible in most cases, so the principal surgical objective is reduction and decompression. The best prognosis is seen in patients with low grade tumors with minimal neurologic deficit. Most of these tumors cause death in a short period, usually one year or less.
Asunto(s)
Neoplasias del Tronco Encefálico , Neoplasias del Tronco Encefálico/diagnóstico , Neoplasias del Tronco Encefálico/patología , Neoplasias del Tronco Encefálico/cirugía , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Procedimientos Neuroquirúrgicos , Pronóstico , Resultado del TratamientoRESUMEN
We report an exceptional case of cauda equina syndrome, caused by a chronic epidural hematoma of the lumbar spine, (L2-L3). A 53 year old man without history of trauma, lumbar punctures or antiagregant medication, suffered from progressive back pain and minor motor deficit in the legs. The etiology, MRI, intraoperative findings and microscopical study are presented and discussed. After surgery there was a complete resolution of the clinical picture.
Asunto(s)
Hematoma Espinal Epidural/diagnóstico , Vértebras Lumbares/patología , Cauda Equina/patología , Cauda Equina/cirugía , Enfermedad Crónica , Descompresión Quirúrgica , Hematoma Espinal Epidural/patología , Hematoma Espinal Epidural/cirugía , Humanos , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/cirugía , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , RadiografíaRESUMEN
Presentamos un caso excepcional de estenosis decanal lumbar con síndrome de cola de caballo por un hematoma crónico espontáneo en el espacio epiduralL2-L3.Se trata de un varón de 53 años que, sin ninguna clase de antecedente patológico relacionado con el problema actual (traumatismos, punciones lumbares, toma de antiagregantes o anticoagulantes), presenta una colección hemática epidural que va comprimiendo progresivamente la cola de caballo. Las pruebas de imagen mostraron una colección polilobulada, bien delimitada, que se interpretó como quiste sinovial. Tras la cirugía (laminectomía descompresiva y evacuación) se confirmó el diagnóstico con estudio histológico. Tras la operación se recuperó por completo la función neurológica
We report an exceptional case of cauda equina syndrome, caused by a chronic epidural hematoma of the lumbar spine, (L2-L3). A 53 year old man without history of trauma, lumbar punctures or antiagregant medication, suffered from progressive back pain and minor motor deficit in the legs. The etiology, MRI, intraoperative findings and microscopical study are presented and discussed. After surgery there was a complete resolution of the clinical picture